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    By Suven Bhattacharjee, MS
    AAO 2014
    Cataract/Anterior Segment

    This video demonstrates how a number of adverse conditions in a case of hypermature cataract were overcome and an in-the-bag IOL implantation was performed. First, trypan blue staining was patchy, with large geographical areas left unstained for no apparent reason. With a friable anterior capsule that tore like wet blotting paper and extensive areas of subcapsular fibrosis and adhesions, it was impossible to shape a continuous curvilinear capsulorhexis. The result was an anterior capsulorhexis with multiple jagged edges – each one with the potential to run to the periphery. With this threat looming, large phacoemulsification had to be performed on this dense nucleus.